Venous Leg Ulcers: Advanced Therapies and New Technologies

Abstract

The prevalence of venous leg ulcers (VLUs) differs between 1.5% and 3% in the general population. The challenge in treating VLUs is common recurrence. Moreover, VLUs can be resistant to healing, despite appropriate treatment. In these cases, advanced wound therapies should be considered. The number of new technologies, applied in VLUs treatment, has increased in the last years. These therapies include biophysical interventions such as ultrasound therapy, electrical stimulations, electromagnetic therapy, or phototherapy. Furthermore, stem cell therapies, biologic skin equivalents, platelet-rich plasma therapy, oxygen therapies, anti-TNF therapy, or negative pressure wound therapy are advanced venous ulcer therapeutic methods that may support the standard of care. Medical devices, such as a muscle pump activator, or intermittent pneumatic compression device, may be especially useful for specific subgroups of patients suffering from VLUs. Some of the above-mentioned technologies require broader evidence of clinical efficacy and are still considered experimental therapies in dermatology.

In Vitro and In Vivo Characterization Methods for Evaluation of Modern Wound Dressings

“…In addition, traditional wound dressings do not provide enough wound drainage, require frequent changes associated with pain, and lack desired mechanical properties, adhesion properties, stimuli-responsiveness properties, and inherent bioactivity. Furthermore, additional challenges are presented by the large volume of wound exudates associated with chronic wounds present additional challenges [ 21 ]. Therefore, there is an urgent need to normalize the healing process through utilization of wound dressings with the ability to address the abnormal changes happening during chronic wound healing for effective and timely wound treatment.…”

Ulcus cruris venosum

“…Neben einer Optimierung der invasiven Verfahren liegt vor allem in der Entwicklung adjuvanter Therapiemodalitäten noch großes Potenzial. Dies inhautnah kludiert unter anderem folgende Technologien: elektrische Stimulation, Ultraschalltherapie, elektromagnetische Therapie, Photobiomodulation, Sauerstofftherapie, Platelet-Rich-Plasma-Therapie, Biologika oder Zelltherapie [67]. Ob diese Therapien tatsächlich einen relevanten Effekt beim UCV haben, werden erst zukünftige Untersuchungen zeigen.…”

Surgical outcomes of split-thickness skin grafts versus free flaps of the lateral thoracic region for incurable chronic venous ulcers

“…Moreover, various biophysical therapies, including ultrasonography, electrostimulation, and phototherapy, have been used in recent years to treat CVU, while other methods, including stem cell therapy, plasma therapy, oxygen therapy, and antitumor necrosis factor therapy, have also been attempted. However, the clinical efficacy of these treatment modalities still needs to be proven and many of these methods are still in the experimental stage [6].…”